Periodontal Surgery Involving Modified Widman Flap Procedure and Connective Tissue Graft for Generalized Aggressive Periodontitis: A Case Report. 2016

Kentaro Imamura, and Yuri Okamura, and Yasugi Matsumoto, and Yuko Mashimo, and Sachiyo Tomita, and Hiroki Sugito, and Atsushi Saito
Department of Periodontology, Tokyo Dental College.

We report a case of generalized aggressive periodontitis (AgP) requiring periodontal treatment including flap surgery and ridge augmentation. The patient was a 39-year-old woman who presented with the chief complaint of pus discharge from tooth #36. No other obvious signs of gingival inflammation were observed. Periodontal examination revealed multiple sites with a probing depth of ≥10 mm. Radiography showed pro-nounced bone defects in the maxillary incisors and molar region. Real-time PCR was used to detect Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia in subgingival plaque; all 3 pathogens were found. Based on a clinical diagnosis of generalized AgP, periodontal therapy was initiated, which resulted in an improvement in clinical and microbiological parameters. A modified Widman flap procedure was then performed on sites with residual periodontal pockets. Next, a connective tissue graft was performed for ridge augmentation at #22, which had shown evidence of ridge resorption. Postoperative reevaluation revealed a reduction in probing depth and an improvement in marginal bone levels. Oral function was then restored using a fixed bridge prosthesis and maintenance therapy initiated. The periodontal condition has remained stable over a 2.5-year period. In the present case of AgP, surgical intervention reduced periodontal pockets and periodontal pathogens and improved the architecture of both the hard and soft tissues, allowing subsequent care of the periodontium to be performed efficiently by the patient.

UI MeSH Term Description Entries
D010514 Periodontal Pocket An abnormal extension of a gingival sulcus accompanied by the apical migration of the epithelial attachment and bone resorption. Pocket, Periodontal,Periodontal Pockets,Pockets, Periodontal
D010520 Aggressive Periodontitis Inflammation and loss of PERIODONTIUM that is characterized by rapid attachment loss and bone destruction in the presence of little local factors such as DENTAL PLAQUE and DENTAL CALCULUS. This highly destructive form of periodontitis often occurs in young people and was called early-onset periodontitis, but this disease also appears in old people. Periodontitis, Juvenile,Periodontitis, Prepubertal,Periodontosis,Early-Onset Periodontitis,Juvenile Periodontitis,Periodontitis, Aggressive, 1,Periodontitis, Circumpubertal,Prepubertal Periodontitis,Circumpubertal Periodontitis,Early Onset Periodontitis,Early-Onset Periodontitides,Juvenile Periodontitides,Periodontitides, Early-Onset,Periodontitides, Juvenile,Periodontitis, Aggressive,Periodontitis, Early-Onset,Periodontoses
D003238 Connective Tissue Tissue that supports and binds other tissues. It consists of CONNECTIVE TISSUE CELLS embedded in a large amount of EXTRACELLULAR MATRIX. Connective Tissues,Tissue, Connective,Tissues, Connective
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000540 Alveolar Ridge Augmentation Preprosthetic surgery involving rib, cartilage, or iliac crest bone grafts, usually autologous, or synthetic implants for rebuilding the alveolar ridge. Mandibular Ridge Augmentation,Maxillary Ridge Augmentation,Alveolar Ridge Augmentations,Augmentation, Alveolar Ridge,Augmentation, Mandibular Ridge,Augmentation, Maxillary Ridge,Augmentations, Alveolar Ridge,Augmentations, Mandibular Ridge,Augmentations, Maxillary Ridge,Mandibular Ridge Augmentations,Maxillary Ridge Augmentations,Ridge Augmentation, Alveolar,Ridge Augmentation, Mandibular,Ridge Augmentation, Maxillary,Ridge Augmentations, Alveolar,Ridge Augmentations, Mandibular,Ridge Augmentations, Maxillary
D013524 Surgical Flaps Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region. Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps

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